| NPI | 1568850113 |
|---|---|
| Former Name | STACY L. GROVE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012474) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 209012474) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2019-01-04 |